Mary Bogle Psy D LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

MARY BOGLE PSY D LLC

Practice address

11630 SE 40TH Ave Ste a
Milwaukie, OR 97222-6195

Phone

(503) 303-3740

NPI assigned

Jun 21, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary BogleNPI 1083744536

Title

Clinical Psychologist

Phone

(503) 303-3740

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Bogle

  • Clinical Psychologist
  • Portland, OR
  • NPI 1083744536
  Medicare reassignment NPD Authorized official
• David Mealey, D.C.

  • Chiropractor
  • Milwaukie, OR
  • NPI 1386788875
  NPD
• James Scott Bowman, D.C.

  • Chiropractor
  • Portland, OR
  • NPI 1083911663
  NPD (past)
• Blaire M Nichols, LMT

  • Reflexologist
  • Milwaukie, OR
  • NPI 1023340817
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1881325892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 SE LAKE RD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11630 SE 40TH AVE STE A",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226195",
            "telephone_number": "503-303-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BOGLE PSY D LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-21",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "BOGLE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "503-303-3740",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helme R Marticorena
• Lorelei Martin, PTA
• Carmen D Martinez, OTR
• Heather Martinez, CSWA
• Elizabeth Martino, DPT
• Patricia Anne Maski, PHYSICAL THERAPIST
• David R. Maslen, MD
• Eileen Masover, MSW
• Markus Mastrud, RN
• Cathy I Matheson, ORTL

• Clinical Psychologist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.